| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
17,744 |
14,818 |
$2.16M |
| 92014 |
|
18,619 |
15,817 |
$1.41M |
| 92004 |
|
13,143 |
11,321 |
$1.21M |
| V2020 |
Vision svcs frames purchases |
25,757 |
21,063 |
$798K |
| 92134 |
|
22,659 |
18,877 |
$625K |
| V2750 |
Anti-reflective coating |
27,612 |
22,887 |
$552K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
16,570 |
13,572 |
$543K |
| 92340 |
|
26,331 |
22,007 |
$377K |
| V2784 |
Lens polycarb or equal |
24,726 |
20,208 |
$325K |
| 92250 |
|
8,065 |
7,340 |
$262K |
| 92310 |
|
2,437 |
2,272 |
$251K |
| V2521 |
Cntct lens hydrophilic toric |
1,964 |
1,780 |
$214K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
4,458 |
3,789 |
$163K |
| V2100 |
Lens spher single plano 4.00 |
5,257 |
4,297 |
$157K |
| V2520 |
Contact lens hydrophilic |
1,736 |
1,577 |
$118K |
| V2025 |
Eyeglasses delux frames |
1,034 |
985 |
$115K |
| 92015 |
|
32,659 |
27,792 |
$30K |
| V2107 |
Spherocylinder 4.25d/12-2d |
425 |
362 |
$19K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
142 |
118 |
$7K |
| V2523 |
Cntct lens hydrophil extend |
30 |
27 |
$4K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
18 |
13 |
$910.78 |
| 92135 |
|
13 |
13 |
$0.00 |